• Ovarian Cancer
• Vulvar and Vaginal Cancer
• Urinary Incontinence and prolapse
• Uterine Cancer
• Genetic Testing
• Chemotherapy

   

Chemotherapy

Chemotherapy is the use of anticancer drugs to treat cancerous cells. During chemotherapy, treatment is modified based on the outcome during and following treatment.  In the course of treatment, patients may achieve remission status whereby cancer can no longer be detected by clinical studies, laboratory studies or physical examination. At this time chemotherapy may be discontinued and the patient may begin surveillance.  Should remission last beyond five years, patients may be considered cured of disease.

Alteration in the chemotherapy plan may occur in the event of cancer persisting or progressing despite treatment.  In these situations, the cancer may be deemed resistant to chemotherapy regimen, and the regimen may be changed.  The patient continues being evaluated with clinical studies, laboratory studies and physical examination.

In the event of cancer progression, despite changes in therapy, patients may elect supportive care and pursue quality of life measures without efforts to prolong life with chemotherapy.  Patients may also pursue no further chemotherapy should side effects become intolerable.

Treatment outcomes as described above may be more concisely interpreted as follows:

• Complete response: the complete disappearance of all clinical evidence of tumor, including normalization of laboratory studies such as tumor markers (CA-125 in ovarian cancer) , as determined by two observations not less than 4 weeks apart.
• Partial response: a greater than 50% decrease in the sum of the product of measured lesions, as determined by two observations not less than 4 weeks apart.
• Stable disease: a steady state of response, with no change in size or laboratory marker level, lasting at least 4 weeks
• Progressive disease: an unequivocal increase of as least 50 % in the product of the measured lesion. New lesions may also occur.

Adjective terminology used for chemotherapy

• Induction: given when no alternative treatment is available, ie surgery.
• Adjuvant: used after initial surgical or radiation therapy to minimize recurrence risk when no detectable tumor present.
• Salvage: used after recurrence of cancer or with tumor resistant to previous chemotherapy.
• Chemosensitizing: given concurrently with radiation to increase susceptibility of cancer to radiation.  Chemotherapy is usually administered in lower doses in this context.
• Neoadjuvant: given prior to definitive treatment (surgery or radiation) in order to reduce tumor size and allow less extensive surgery or radiation therapy.

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